Poli‐nezasićene masne kiseline (PUFA) za djecu s određenim poremećajima učenja
Abstract
Background
About 5% of schoolchildren have a specific learning disorder, defined as an unexpected failure to acquire adequate abilities in reading, writing or mathematic skills not as a result of reduced intellectual ability, inadequate teaching or social deprivation. Of these, 80% are reading disorders. Polyunsaturated fatty acids (PUFAs), in particular omega‐3 and omega‐6 fatty acids, which are found abundantly in the brain and retina are important for learning. Some children with specific learning disorders have been found to be deficient in these PUFAs, and it is argued that supplementation of PUFAs may help these children improve their learning abilities.
Objectives
To assess the effects of polyunsaturated fatty acids (PUFAs) supplementation for children with specific learning disorders, on learning outcomes.
Search methods
We searched the following databases in April 2012: CENTRAL (2012, Issue 4), MEDLINE (1948 to April Week 2 2012), EMBASE (1980 to 2012 Week 16), PsycINFO (1806 to April 2012), ERIC (1966 to April 2012), Science Citation Index (1970 to 20 April 2012), Social Science Citation Index (1970 to 20 April 2012), Conference Proceedings Citation Index‐Science (1970 to 20 April 2012), Conference Proceedings Citation Index‐Social Sciences and Humanites (1970 to 20 April 2012), Cochrane Database of Systematic Reviews (2012, Issue 4), DARE (2012, Issue 2) , ZETOC (24 April 2012) and WorldCat (24 April 2012). We searched the WHO International Clinical Trials Registry Platform and ClinicalTrials.gov on 24 April 2012. We also searched the reference lists of relevant articles identified by the searches.
Selection criteria
Randomised or quasi‐randomised controlled trials comparing polyunsaturated fatty acids (PUFAs) with placebo or no treatment in children aged below 18 years with specific learning disabilities diagnosed using DSM‐IV, ICD‐10 or equivalent criteria. We intended to include participants with co‐existing developmental disorders such as attention deficit hyperactivity disorder (ADHD) or autism.
Data collection and analysis
Two authors (ML and KH) independently screened the titles and abstracts of the search results and eliminated all studies that did not meet the inclusion criteria. Authors were contacted for missing information and clarifications when needed.
Main results
We did not find any studies suitable for inclusion in the review. One study is awaiting classification as we were unable to get any information from the study author.
Authors' conclusions
There is insufficient evidence to draw any conclusion about the use of PUFAs for children with specific learning disorders. There is a need for well designed randomised studies to support or refute the use of PUFAs in this group of children.
PICO
Plain language summary
Višestruko‐nezasićene masne kiseline za djecu s određenim poremećajima učenja
U slučaju da su sposobnosti djece u savladavanju čitanja, slovkanja, pisanja i matematike značajno ispod prosjeka očekivanog za njihove godine, a nisu posljedica nižeg kvocijenta inteligencije, neprikladnog podučavanja ili odsutnosti socijaliziranja smatra se da ona imaju određene poremećaje učenja. Ti se poremećaji mogu javiti pojedinačno (npr. samo poremećaj čitanja) ili u kombinaciji (poremećaj čitanja i savladavanja matematike). Također se mogu javiti i u kombinaciji s nekim drugim razvojnim problemom kao što je poremećaj nedostatka pozornosti ili hiperaktivni poremećaj (ADHD). Višestruko nezasićene masne kiseline (engl. polyunsaturated fatty acids, PUFA) smatraju se "hranom za mozak" i farmaceutske tvrtke promoviranju njihovu uporabu, obično kao omega‐3 masne kisline ili dokozaheksaenoična kiselina (DHA) za poboljšanje sposobnosti učenja. Cilj ovog Cochrane sustavnog pregleda bio je procijeniti učinak nadomjestaka PUFA na čitanje, pisanje, slovkanje i matematičke sposobnosti u djece sa specifičnim poremećajima učenja. Pronađena je jedna studija koja je analizirala učinak PUFA u usporedbi s placebom na čitanje, slovkanje ili matematičke vještine u djece sa specifičnim poremećajima učenja. Međutim, ta studija nije se mogla uključiti u ovaj sustavni pregled literature jer je u isto vrijeme korišten i jedan drugi aktivni sastojak ‐ karnozin. Pronađena je i još jedna studija koja se nije mogla uključiti zbog manjkavih informacija. Stoga nema dovoljno dokaza da bi se moglo zaključiti da PUFA mogu biti korisne ili ne mogu biti korisne za djecu sa specifičnim poremećajima učenja.
